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Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
Yoav Eizenberg, Ehud Grossman, David Tanne, Silvia Koton
The impact of beta-blockers (BB) treatment on stroke outcome is unclear. We used data from a prospective national stroke registry to assess the associations between use of BB and poor outcome 3 months after stroke. Using the National Acute Stroke Israeli (NASIS) registry, we identified 1126 patients with ischemic stroke and intracerebral hemorrhage with pre-stroke hypertension treatment, who were followed for 3-months. Functional outcome and mortality at 3-month were compared by use of BB, adjusting for demographics and clinical factors...
March 9, 2018: Journal of Clinical Hypertension
Xiaoxing Lai, Hongwei Zhu, Xiaopeng Huo, Zheng Li
BACKGROUND: The oldest old generally have worse health and more comorbidities than the general population of older adults, and they are more likely to be exposed to polypharmacy. Reliable investigation of polypharmacy among the oldest old (≥80 years of age) in China are lacking. So this study aims to describe the polypharmacy status of oldest old patients ≥80 years of age and to assess the factors influencing medication compliance. METHODS: This was a cross-sectional study of 258 oldest old patients ≥ 80 years of age and hospitalized at a tertiary hospital in Beijing between December 1, 2014 and June 30, 2015...
March 2, 2018: BMC Geriatrics
Joshua H Hill, Paul Bonner, M Shay O'Mara, Teresa Wood, Michael Lieber
OBJECTIVE: We postulate that in patients with blunt trauma on anticoagulant or antiplatelet agents, incidence and complication rate of delayed intracranial hemorrhage (DICH) after an initially negative head CT is low and routine repeat head CT is not warranted. DESIGN: A retrospective, observational study performed from 2008 to 2012. PATIENTS: A total of 338 patients with blunt trauma with pre-admission history of any anticoagulant use, who had an initially negative head CT, followed by a repeat CT within 48 hours...
February 27, 2018: Brain Injury: [BI]
Claire Smith-Gowling, Susan F Knowles, Suzanne Hodge
As adolescent self-harm is a growing public health concern, more research is needed to identify potential risk factors. Studies have highlighted that exposure to the self-harm of others may be a risk factor associated with engagement in self-harm. However, research investigating young people's experiences of the self-harm of others has been limited. This qualitative study aimed to explore young people's experiences of the self-harm of others and interviewed a total of eight young people (five females and three males; aged between 13 and 18 years) resident at one of two adolescent mental health inpatient units in the North of England...
February 1, 2018: Clinical Child Psychology and Psychiatry
Carolin Hoyer, Alexandra Filipov, Eva Neumaier-Probst, Kristina Szabo, Anne Ebert, Angelika Alonso
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) have gained increasing importance for stroke prevention in patients with non-valvular atrial fibrillation (AF). With changing prescription practice, among other factors, clinicians can expect to see rising numbers of patients with ischemic stroke and pre-existing NOAC therapy. Few data exist regarding a potential impact of NOAC on stroke severity and outcome. AIMS: To evaluate the impact of pre-admission NOAC therapy on ischemic stroke severity...
February 23, 2018: Journal of Thrombosis and Thrombolysis
Takahiro Ushijima, Kenichi Kawaguchi, Tadashi Matsumoto, Masaki Takagi, Tatsuro Kondoh, Gen Nishimura, Aritoshi Iida, Shiro Ikegawa, Nobuhiko Haga, Go Kato
BACKGROUND: Patients with ankylosing spines are susceptible to developing spinal fractures even with minor trauma and can develop early or late neurological injuries. These fractures require early and aggressive surgical management to enable spinal stability and/or neural decompression. Being highly unstable by nature, they require relatively long segment instrumentation and fusion, which can increase paravertebral soft tissue damage and perioperative bleeding. The purpose of this report is to describe a rare case of traumatic double fractures at the cervico-thoracic and thoraco-lumbar transition zones in ankylosing spine with spondylo-epiphyseal dysplasia (SED) of unknown cause, which were successfully treated with a combined open and percutaneous spinal fusion procedure...
February 7, 2018: BMC Research Notes
M Pourhassan, K Norman, M J Müller, R Dziewas, R Wirth
OBJECTIVES: However, the information regarding the impact of sarcopenia on mortality in older individuals is rising, there is a lack of knowledge concerning this issue among geriatric hospitalized patients. Therefore, aim of the present study was to investigate the associations between sarcopenia and 1-year mortality in a prospectively recruited sample of geriatric inpatients with different mobility and dependency status. DESIGN AND SETTING: Sarcopenia was diagnosed using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP)...
2018: Journal of Frailty & Aging
Ingo Bergmann, Benedikt Büttner, Elena Teut, Claudius Jacobshagen, José Hinz, Michael Quintel, Ashham Mansur, Markus Roessler
BACKGROUND: Non-ST elevation myocardial infarction (NSTEMI) is a common manifestation of acute coronary syndrome (ACS), but delayed diagnosis can increase mortality. In this proof of principle study, the emergency physician performed transthoracic echocardiography (TTE) on scene to determine whether NSTEMI could be correctly diagnosed pre-hospitalization. This could expedite admission to the appropriate facility and reduce the delay until initiation of correct therapy. METHODS: Pre-hospital TTE was performed on scene by the emergency physician in patients presenting with ACS but without ST-elevation in the initial 12-lead electrocardiography (ECG) (NSTE-ACS)...
February 7, 2018: Critical Care: the Official Journal of the Critical Care Forum
Supakanya Wongrakpanich, Christos Kallis, Prithiv Prasad, Janani Rangaswami, Andrew Rosenzweig
Rhabdomyolysis is a syndrome caused by injury to skeletal muscle. There is limited data of rhabdomyolysis in the elderly. The objective of this study is to investigate demographic data, etiologies, laboratory values, prognostic factors, and mortality of rhabdomyolysis in the geriatric population. A 4-years retrospective chart review study was conducted. Our inclusion criteria were age above 65 years and creatinine kinase level excess five times of normal upper limit. Among 167 patients, 47.3% were male. The median age at diagnosis was 80...
February 2018: Aging and Disease
Lana Salameh, Rana Abu Farha, Iman Basheti
Objectives: Medication errors are considered among the most common causes of morbidity and mortality in hospital setting. Among these errors are discrepancies identified during transfer of patients from one care unit to another, from one physician care to another, or upon patient discharge. Thus, the aims of this study were to identify the prevalence and types of medication discrepancies at the time of hospital admission to a tertiary care teaching hospital in Jordan and to identify risk factors affecting the occurrence of these discrepancies...
January 2018: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Anna Zisberg, Orly Tonkikh, Gary Sinoff, Hanna Admi, Chen Shapira, Nurit Gur-Yaish, Efrat Shadmi
INTRODUCTION: Hospital-associated functional decline (HAFD) is recognized as a leading cause of adverse hospitalization outcomes, such as prolonged hospitalization, falls, readmission, and mortality. Since most patients hospitalized in internal medicine wards are older-adults, HAFD presents a major challenge to internal medicine. OBJECTIVES: Describe functional trajectories of older-adults (aged ≥70 years) before, during and after acute hospitalization in internal-medicine units...
January 2018: Harefuah
Benjamin J Lee, Alan S Go, Rishi Parikh, Thomas K Leong, Thida C Tan, Sophia Walia, Raymond K Hsu, Kathleen D Liu, Chi-Yuan Hsu
Renal recovery after dialysis-requiring acute kidney injury (AKI-D) is an important clinical and patient-centered outcome. Here we examined whether the pre-admission proteinuria level independently influences risk for non-recovery after AKI-D in a community-based population. All adult members of Kaiser Permanente Northern California who experienced AKI-D between January 1, 2009 and September 30, 2015 were included. Pre-admission proteinuria levels were determined by dipstick up to four years before the AKI-D hospitalization and the outcome was renal recovery (survival and dialysis-independence four weeks and more) at 90 days after initiation of renal replacement therapy...
January 9, 2018: Kidney International
Amit Akirov, Oren Amitai, Hiba Masri-Iraqi, Talia Diker-Cohen, Tzipora Shochat, Yoav Eizenberg, Ilan Shimon
Hypoglycemia is common among hospitalized patients with diabetes mellitus (DM), and is associated with increased morbidity and mortality. Identify pre-admission risk factors associated with in-hospital hypoglycemia. Historical prospectively collected data of adult DM patients hospitalized to medical wards between 2011 and 2013. Hypoglycemia and serious hypoglycemia were defined as at least one blood glucose measurement ≤ 70 and < 54 mg/dl, respectively, during hospitalization. The primary outcome was in-hospital hypoglycemia...
January 16, 2018: Internal and Emergency Medicine
Fergus William Gardiner, Ezekiel Uba Nwose, Phillip Taderera Bwititi, Judith Crockett, Lexin Wang
AIMS: To determine the extent to which targets for blood pressure (BP) (<140.90 mmHg) and random blood glucose level (BGL) (<7.7 mmol/L) control in patients with chronic kidney disease (CKD) are achieved; and the extent clinical inertia affects BP and glucose control in CKD and diabetes mellitus (DM). METHODS: Data was collected from the 1st January 2015 until 31st December 2015 on key patient pathology, admission reason, final discharge diagnosis, and information concerning clinical guideline adherence...
December 16, 2017: Diabetes & Metabolic Syndrome
Y Terada, S Inoue, M Konda, J Egawa, J Ueda, T Kirita, M Kawaguchi
OBJECTIVE: Cognitive impairment after intensive care unit (ICU) admission is becoming increasingly recognized. High-dose deep sedation has been suggested to play an important role in the development of cognitive impairment. However, the impact of heavy sedation as a single cause in the development of cognitive impairment in ICU patients remains unclear. In this study we investigated whether a three-day deep sedation protocol could reduce cognitive function in mechanically ventilated non-critical patients...
December 16, 2017: Medicina Intensiva
M Elle Saine, Mona Gizaw, Dena M Carbonari, Craig W Newcomb, Jason A Roy, Serena Cardillo, Daina B Esposito, Harshvinder Bhullar, Arlene M Gallagher, Brian L Strom, Vincent Lo Re
PURPOSE: Identification of hospitalizations for infection is important for post-marketing surveillance of drugs, but the validity of using diagnosis codes to identify these events is unknown. Differentiating between hospitalization for and with infection is important, as the latter is common and less likely to arise from pre-admission exposure to drugs. We determined positive predictive values (PPVs) of diagnostic coding-based algorithms to identify hospitalization for infection among patients prescribed oral anti-diabetic drugs (OADs)...
December 18, 2017: Pharmacoepidemiology and Drug Safety
Eirik Roos, Ottar Bjerkeset, Margrét Hrönn Svavarsdóttir, Aslak Steinsbekk
BACKGROUND: The discharge process from hospital to home for patients with severe mental illness (SMI) is often complex, and most are in need of tailored and coordinated community services at home. One solution is to discharge patients to inpatient short-stay community residential aftercare (CRA). The aim of this study was to explore how patients with SMI experience a stay in CRA established in a City in Central Norway. METHODS: A descriptive qualitative study with individual interviews and a group interview with 13 persons...
December 16, 2017: BMC Health Services Research
Nicolas Girerd, Marie-France Seronde, Stefano Coiro, Tahar Chouihed, Pascal Bilbault, François Braun, David Kenizou, Bruno Maillier, Pierre Nazeyrollas, Gérard Roul, Ludivine Fillieux, William T Abraham, James Januzzi, Laurent Sebbag, Faiez Zannad, Alexandre Mebazaa, Patrick Rossignol
Congestion is one of the main predictors of poor patient outcome in patients with heart failure. However, congestion is difficult to assess, especially when symptoms are mild. Although numerous clinical scores, imaging tools, and biological tests are available to assist physicians in ascertaining and quantifying congestion, not all are appropriate for use in all stages of patient management. In recent years, multidisciplinary management in the community has become increasingly important to prevent heart failure hospitalizations...
December 6, 2017: JACC. Heart Failure
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